系统性红斑狼疮患者外周血树突状细胞的变化及意义

Changes and significances of dendritic cells in peripheral blood of patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者外周血浆细胞树突状细胞(PDC)和髓样树突状细胞的(MDC)的比例以及细胞因子干扰素α(IFN-α)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)的变化及意义。方法选择38例SLE患者(SLE组)、15例健康志愿者(正常对照组)。采用流式细胞术检测PDC、MDC占淋巴细胞的比例,ELISA法检测外周血IFN-α、IL-6、TNF-α水平。结果①SLE组外周血PDC、MDC比例均显著低于正常对照组。②疾病活动期SLE患者外周血PDC比例显著低于稳定期患者;SLE蛋白尿组外周血PDC比例显著低于非蛋白尿组患者;抗ds-DNA阳性组SLE患者外周血PDC比例显著低于抗ds-DNA阴性组。③PDC比例与血沉、SLE疾病活动指数评分呈负相关,与C3呈正相关。④SLE组与正常对照组相比IFN-α、TNF-α、IL-6水平均增高。结论 SLE患者外周血PDC、MDC比例显著降低,且PDC水平与SLE疾病活动及狼疮肾损害有关。

Objective To detect the ratio of peripheral blood plasmacytoid dendritic cells（PDC） and myeloid dendritic cells（MDC） in patients with systemic lupus erythematosus（SLE）,and to investegate the changes and significances of the levels of peripheral blood IFN-α,IL-6,TNF-α.Methods The ratios of PDC,MDC in peripheral blood from 38 cases SLE and 15 normal individuals were measured by flowcytometer,The concentrations of IFN-α,IL-6,TNF-α were detected by ELISA method.Results ① The level of PDC,MDC in peripheral blood of SLE patients decreased significantly compared with normal controls.② It was also found that the percentage of peripheral blood PDC in SLE patients with stable disease was significantly higher than that in patients with active disease.SLE patients with proteinuria had lower level of PDC compared with patients without proteinuria.In addition,anti dsDNA negative patients had higher percentage of PDC than that of anti-ds-DNA positive patients.③ The ratios of PDC were correlated with SLEDAI,C3 and ESR significantly.④ Further study still found SLE patients secreted higher level of IFN-α,IL-6,TNF-α.Conclusion The ratio of PDC decreases in SLE patients.The decreasing level of PDC correlates with the activity of SLE and kidney damage.